Table 1: Time to Therapy.
Organism | Number Identified | Average Time to Optimal Therapy (hrs) | Average Time to Targeted Therapy based on FA Result (hrs) | Average Time to Targeted Therapy based on NV result (hrs) |
ESBL Klebsiella pneumoniae | 1 | 29 | 1.15 | 2.5 |
KPC Klebsiella pneumoniae | 1 | 33.9 | 1.15 | 2.5 |
Other gram-negative organisms* | 28 | 55.8 | 1.15 | 2.5 |
MSSA Ŧ | 20 | 52 | 1.15 | 2.0 |
MRSA Τ | 3 | 17.8 | 1.15 | 2.0 |
VRE ¶ | 3 | 48.7 | 1.15 | 2.0 |
Other gram-positive organisms § | 19 | 48.6 | 1.15 | 2.0 |
C. albicans** | 3 | 77.1 | 1.15 | N/A |
All isolates | 77 | 52.3 | 1.15 | 2.0-2.52.0-2.5 |
*11 Pseudomonas aeruginosa, 35 were Enterobacteriaceae, 2 Stenotrophomonas spp., 2 Gemella spp., 1 Pantoea spp., 1 Achromobacter spp., 1 Bacteroides spp., 6 Enterococcus faecalis. For these patients with Gram-negative organisms 28 patients were on therapy that required modification based on susceptibility results.
Τ 3 of 17 patients with MRSA required therapy modification; 2 patients were not initiated on vancomycin (1 not initially treating the isolate prior to susceptibilities and 1 was receiving alternative Gram-positive coverage with linezolid that was modified to bactericidal antibiotic daptomycin after susceptibilities known), 1 patient was started on vancomycin initially, but after MIC of 2 was reported with susceptibilities it was changed to daptomycin for targeted therapy.
Ŧ 20 of 22 patients with MSSA required therapy modification, 2 patients continued on vancomycin despite susceptibility result.
¶ 3 of 5 patients with VRE required modification in therapy.
§ Coagulase negative Staphylococcus spp. (CoNS) (n = 30), Streptococcus spp. (n = 11), Bacillus spp. (n = 1), and Corynebacterium spp. (n=1). For the 43 patients with other Gram-positive organisms, 15 required modification based on susceptibility results.
**All 3 patients with C. albicans required therapy modification, however 1 patient remained on broader spectrum amphotericin, despite susceptibility results - this patient was deemed as being on appropriate targeted therapy as ID consult was following the patient and recommended continuation of amphotericin as optimal targeted therapy for this patient.